The city rankings produced by the latest round of the Swachh Survekshan survey shouldn’t come as a surprise. The usual suspects dominate at both ends of the list. It is important to note here that the results go beyond quality of life or civic pride.

Urban sanitation is intricately linked with urban health trends. For instance, there is considerable empirical work linking maternal and child health outcomes—a major developmental issue—in cities to sanitation. A 2015 Institute for Fiscal Studies paper by Britta Augsburg and Paul Rodriguez-Lesmes, Sanitation and child health in India, which found sanitation to have a strong causal link with child stunting is a good example of this.

A look at the survey rankings in the context of statistics put out by the ministry of health and family welfare bears this out. Thus, cities in states like Uttar Pradesh and Rajasthan that, on the whole, fare poorly in the former also fare poorly when it comes to the latter. Cleaning India’s cities will go a long way towards improving health outcomes—and thus boosting growth.